MEDICARE: JAYJAY SAPIGAO DMD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1205599933
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAYJAY SAPIGAO DMD INC

Provider Business Mailing Address
First Line	:	31280 BOB HOPE DR STE 102
Second Line	:
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92276-1105
Country	:	US
Telephone Number	:	760-422-3888
Fax Number	:

Provider Business Practice Location Address
First Line	:	31280 BOB HOPE DR STE 102
Second Line	:
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92276-1105
Country	:	US
Telephone Number	:	760-422-3888
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. JAYJAY SAPIGAO
Credential	:	DMD
Telephone Number	:	760-422-3888

Provider Enumeration Date	:	10/19/2021
Last Update Date	:	10/19/2021

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